Case 4: An 80-year-old woman was admitted with a diagnosis of hypertension, cong
ID: 55075 • Letter: C
Question
Case 4: An 80-year-old woman was admitted with a diagnosis of hypertension, congestive heart failure, anemia, possible diabetes and chronic renal failure. She was treated with diuretics and IV fluids and released 4 days later. Her lab results are shown below (2/11 and 2/15).
Five months later, she was re-admitted for treatment of repeated bouts of dyspnea. She was placed on a special diet and drugs to control her hypertension and was discharged. It was felt that she had not been taking her medication as prescribed and she was counseled regarding the importance of regular doses.
Test
2/11
2/15
7/26
7/28
BUN, mg/dL
58
*
*
61.0
Creatinine, mg/dL
6.2
6.2
6.4
6.0
Uric Acid
10.0
*
*
9.2
BUN/Creatinine
#
*
*
#
Glucose
86
80
113
*
* means the test was not done
# means you need to calculate the number
Questions:
What is the most probable cause of the patient’s elevated BUN? What data support your conclusion?
Note that this patient’s admitting diagnosis is “possible diabetes.” If this patient had truly been a diabetic with an elevated blood glucose and positive ketone, what effect would this have had on the measured values for creatinine? Explain.
What can cause chronic renal failure?
What is the prognosis for this disease?
Please Answer all the questions
Test
2/11
2/15
7/26
7/28
BUN, mg/dL
58
*
*
61.0
Creatinine, mg/dL
6.2
6.2
6.4
6.0
Uric Acid
10.0
*
*
9.2
BUN/Creatinine
#
*
*
#
Glucose
86
80
113
*
Explanation / Answer
The patients elevated BUN is the result of chronic renal failure, along with congestive heart failure. The test results taken on 7/28 show the elevated BUN levels.
Type 1 or type 2 diabetes, High blood pressure, and Glomerulonephritis are the main reason for causing the chronic renal failure.
The most effective prognosis for this condition is kidney transplantation, which will halt the progression of chronic renal failure and relative symptoms.
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